Acute and Critical Care

Volume 35 (2); May 2020

Review Article

Basic science and research
Sepsis-induced cardiac dysfunction: a review of pathophysiology: Reverien Habimana, Insu Choi, Hwa Jin Cho, Dowan Kim, Kyoseon Lee, Inseok Jeong; Acute Crit Care. 2020;35(2):57-66. Published online May 31, 2020; DOI: https://doi.org/10.4266/acc.2020.00248

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It is well known that cardiac dysfunction in sepsis is associated with significantly increased mortality. The pathophysiology of sepsis-induced cardiac dysfunction can be summarized as involving impaired myocardial circulation, direct myocardial depression, and mitochondrial dysfunction. Impaired blood flow to the myocardium is associated with microvascular dysfunction, impaired endothelium, and ventriculo-arterial uncoupling. The mechanisms behind direct myocardial depression consist of downregulation of β-adrenoceptors and several myocardial suppressants (such as cytokine and nitric oxide). Recent research has highlighted that mitochondrial dysfunction, which results in energy depletion, is a major factor in sepsis-induced cardiac dysfunction. Therefore, the authors summarize the pathophysiological process of cardiac dysfunction in sepsis based on the results of recent studies.

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A case of sepsis‐induced cardiomyopathy successfully treated with venoarterial extracorporeal membrane oxygenation
Keigo Sato, Akihiro Naito, Taichi Shiratori, Masahiro Yamamoto, Kenichi Shimane, Manabu Mikami, Mariko Senda, Haruki Kume, Motofumi Suzuki
IJU Case Reports.2023; 6(1): 26. CrossRef
Jujuboside A attenuates sepsis-induced cardiomyopathy by inhibiting inflammation and regulating autophagy
Zi Wang, Danrui Xiao, Qingqi Ji, Yanjie Li, Zhaohua Cai, Liang Fang, Huanhuan Huo, Guo Zhou, Xiangming Yan, Linghong Shen, Ben He
European Journal of Pharmacology.2023; 947: 175451. CrossRef
Mitochondrial transplantation protects against sepsis-induced myocardial dysfunction by modulating mitochondrial biogenesis and fission/fusion and inflammatory response
Behnaz Mokhtari, Masoud Hamidi, Reza Badalzadeh, Ata Mahmoodpoor
Molecular Biology Reports.2023; 50(3): 2147. CrossRef
Therapeutic potentials of stem cell–derived exosomes in cardiovascular diseases
Saiprahalad Mani, Narasimman Gurusamy, Thennavan Ulaganathan, Autumn J Paluck, Satish Ramalingam, Johnson Rajasingh
Experimental Biology and Medicine.2023; 248(5): 434. CrossRef
CLINICAL, MOLECULAR, AND EXOSOMAL MECHANISMS OF CARDIAC AND BRAIN DYSFUNCTION IN SEPSIS
Daniel C. Morris, Zheng Gang Zhang, Anja K. Jaehne, Jing Zhang, Emanuel P. Rivers
Shock.2023; 59(2): 173. CrossRef
Circulating protein and lipid markers of early sepsis diagnosis and prognosis: a scoping review
Gemma Barber, Jelena Tanic, Aleksandra Leligdowicz
Current Opinion in Lipidology.2023; 34(2): 70. CrossRef
Extracellular Histone-Induced Protein Kinase C Alpha Activation and Troponin Phosphorylation Is a Potential Mechanism of Cardiac Contractility Depression in Sepsis
Simon T. Abrams, Yasir Alhamdi, Min Zi, Fengmei Guo, Min Du, Guozheng Wang, Elizabeth J. Cartwright, Cheng-Hock Toh
International Journal of Molecular Sciences.2023; 24(4): 3225. CrossRef
Septic cardiomyopathy: A narrative review
Maria Rita Lima, Doroteia Silva
Revista Portuguesa de Cardiologia.2023; 42(5): 471. CrossRef
Enfoque de la miocardiopatía séptica como causa de choque refractario en escenarios de recursos limitados: reporte de caso
Liliana Correa-Pérez, Diana Carolina Otálora Álvarez, Gloria Camila Álvarez Gallego
Acta Colombiana de Cuidado Intensivo.2023;[Epub] CrossRef
Role of Pellino-1 in Inflammation and Cardioprotection following Severe Sepsis: A Novel Mechanism in a Murine Severe Sepsis Model
Mahesh Thirunavukkarasu, Santosh Swaminathan, Andrew Kemerley, Seetur R. Pradeep, Sue Ting Lim, Diego Accorsi, Rickesha Wilson, Jacob Campbell, Ibnalwalid Saad, Siu-Pok Yee, J. Alexander Palesty, David W. McFadden, Nilanjana Maulik
Cells.2023; 12(11): 1527. CrossRef
High serum nitrates levels in non-survivor COVID-19 patients
L. Lorente, F. Gómez-Bernal, M.M. Martín, J.A. Navarro-Gonzálvez, M. Argueso, A. Perez, L. Ramos-Gómez, J. Solé-Violán, J.A. Marcos y Ramos, N. Ojeda, A. Jiménez
Medicina Intensiva.2022; 46(3): 132. CrossRef
Vital signs as physiomarkers of neonatal sepsis
Brynne A. Sullivan, Karen D. Fairchild
Pediatric Research.2022; 91(2): 273. CrossRef
Fluid therapy for severe malaria
Laura C Kalkman, Thomas Hänscheid, Sanjeev Krishna, Martin P Grobusch
The Lancet Infectious Diseases.2022; 22(6): e160. CrossRef
High serum nitrates levels in non-survivor COVID-19 patients
L. Lorente, F. Gómez-Bernal, M.M. Martín, J.A. Navarro-Gonzálvez, M. Argueso, A. Perez, L. Ramos-Gómez, J. Solé-Violán, J.A. Marcos y Ramos, N. Ojeda, A. Jiménez
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Expression of Peripheral Blood DCs CD86, CD80, and Th1/Th2 in Sepsis Patients and Their Value on Survival Prediction
Ke Du, Shaobo Hao, Heyun Luan, Min Tang
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
Recombinant Activated Protein C (rhAPC) Affects Lipopolysaccharide-Induced Mechanical Compliance Changes and Beat Frequency of mESC-Derived Cardiomyocyte Monolayers
Aysegül Temiz Artmann, Eylem Kurulgan Demirci, Ipek Seda Fırat, Hakan Oflaz, Gerhard M. Artmann
Shock.2022; 57(4): 544. CrossRef
Acute cholecystitis associated with sepsis-induced ischemic cardiomyopathy
Ke-Shiuan Ju, Ying-Shih Su, Wen-Sen Lee
Journal of Infection.2022; 84(6): 834. CrossRef
An Overview on Mitochondrial-Based Therapies in Sepsis-Related Myocardial Dysfunction: Mitochondrial Transplantation as a Promising Approach
Behnaz Mokhtari, Rana Yavari, Reza Badalzadeh, Ata Mahmoodpoor, Jayaraman Tharmalingam
Canadian Journal of Infectious Diseases and Medical Microbiology.2022; 2022: 1. CrossRef
Pathological role of the calcium‐sensing receptor in sepsis‐induced hypotensive shock: Therapeutic possibilities and unanswered questions
Ankita Sood, Gaaminepreet Singh, Thakur G. Singh, Kirti Gupta
Drug Development Research.2022; 83(6): 1241. CrossRef
Diminazene aceturate mitigates cardiomyopathy by interfering with renin-angiotensin system in a septic rat model
Zhaoqing Lu, Di Wu, Zheng Wang, Hanyu Zhang, Yufan Du, Guoxing Wang
BMC Pharmacology and Toxicology.2022;[Epub] CrossRef
Serum Sestrin2 Was Lower in Septic Shock Patients with Cardiomyopathy
Rongjin Huang, Feng Chen, Aiying Zeng, Jun Ke, Shirong Lin, QiXing Chen
Disease Markers.2022; 2022: 1. CrossRef
Tidy up - The unfolded protein response in sepsis
Wolfgang Vivas, Sebastian Weis
Frontiers in Immunology.2022;[Epub] CrossRef
DAMPs Released from Proinflammatory Macrophages Induce Inflammation in Cardiomyocytes via Activation of TLR4 and TNFR
Carolina Neu, Yvonne Thiele, Fabienne Horr, Christian Beckers, Nadine Frank, Gernot Marx, Lukas Martin, Sandra Kraemer, Elisabeth Zechendorf
International Journal of Molecular Sciences.2022; 23(24): 15522. CrossRef
Targeting the TXNIP‐NLRP3 interaction with PSSM1443 to suppress inflammation in sepsis‐induced myocardial dysfunction
Linhua Wang, Hongsheng Zhao, Huifen Xu, Xiangxin Liu, Xinlong Chen, Qingyun Peng, Mingbing Xiao
Journal of Cellular Physiology.2021; 236(6): 4625. CrossRef
Sepsis—Pathophysiology and Therapeutic Concepts
Dominik Jarczak, Stefan Kluge, Axel Nierhaus
Frontiers in Medicine.2021;[Epub] CrossRef
Rho-Proteins and Downstream Pathways as Potential Targets in Sepsis and Septic Shock: What Have We Learned from Basic Research
Maria Luísa da Silveira Hahmeyer, José Eduardo da Silva-Santos
Cells.2021; 10(8): 1844. CrossRef
Deep-learning model for screening sepsis using electrocardiography
Joon-myoung Kwon, Ye Rang Lee, Min-Seung Jung, Yoon-Ji Lee, Yong-Yeon Jo, Da-Young Kang, Soo Youn Lee, Yong-Hyeon Cho, Jae-Hyun Shin, Jang-Hyeon Ban, Kyung-Hee Kim
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2021;[Epub] CrossRef
Levosimendan versus dobutamine for sepsis-induced cardiac dysfunction: a systematic review and meta-analysis
Dong-Hua Liu, Yi-Le Ning, Yan-Yan Lei, Jing Chen, Yan-Yan Liu, Xin-Feng Lin, Zhong-Qi Yang, Shao-Xiang Xian, Wei-Tao Chen
Scientific Reports.2021;[Epub] CrossRef
Exosomes Derived from miR-146a-5p-Enriched Mesenchymal Stem Cells Protect the Cardiomyocytes and Myocardial Tissues in the Polymicrobial Sepsis through Regulating MYBL1
Chun Liu, Jianhua Xue, Bo Xu, Aixian Zhang, Lili Qin, Jiajia Liu, Yang Yang, Antonio C. Campos de Carvalho
Stem Cells International.2021; 2021: 1. CrossRef

Original Articles

Cardiology
Predictors and outcomes of sepsis-induced cardiomyopathy in critically ill patients: Myung Jin Song, Sang Hoon Lee, Ah Young Leem, Song Yee Kim, Kyung Soo Chung, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Joon Chang, Moo Suk Park; Acute Crit Care. 2020;35(2):67-76. Published online May 15, 2020; DOI: https://doi.org/10.4266/acc.2020.00024

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Background
Sepsis-induced cardiomyopathy (SIC) occurs frequently in critically ill patients, but the clinical features and prognostic impact of SIC on sepsis outcome remain controversial. Here, we investigated the predictors and outcomes of SIC.
Methods
Patients admitted to a single medical intensive care unit from June 2016 to September 2017 were retrospectively reviewed. SIC was diagnosed by ejection fraction (EF) <50% and ≥10% decrease in baseline EF that recovered within 2 weeks.
Results
In total, 342 patients with sepsis met the inclusion criteria, and 49 patients (14.3%) were diagnosed with SIC; the latter were compared with 259 patients whose EF was not deteriorated by sepsis (non-SIC). Low systolic blood pressure and increased left ventricular end-diastolic diameter (LVEDD) were identified as predictors of SIC. SIC and non-SIC patients did not differ significantly in terms of 28-day all-cause mortality (24.5% vs. 26.3%, P=0.936). Acute Physiology and Chronic Health Evaluation II (APACHE II; hazard ratio [HR], 1.10; 95% confidential interval [CI], 1.02 to 1.18; P=0.009) and delta neutrophil index (DNI; HR, 1.02; 95% CI, 1.00 to 1.08; P=0.026) were independent risk factors for 28-day mortality with SIC. DNI, APACHE II, and lactate were identified as risk factors for 28-day mortality in sepsis patients as a whole.
Conclusions
SIC was not associated with increased mortality compared to non-SIC. Low systolic blood pressure and increased LVEDD were predictors of SIC. High APACHE II score and elevated DNI, which reflect sepsis severity, predict 28-day all-cause mortality.

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Risk factors of postoperative septic cardiomyopathy in perioperative sepsis patients
Yuchang Xin, Ying Ge, Liuhui Chang, Yong Ni, Hairui Liu, Jiang Zhu
BMC Anesthesiology.2022;[Epub] CrossRef
Effect of milrinone versus placebo on hemodynamic in patients with septic shock: A randomize control trial
Suratee Chobngam, Surat Tongyoo
Clinical Critical Care.2022;[Epub] CrossRef
Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis
Yu-Min Lin, Mei-Chuan Lee, Han Siong Toh, Wei-Ting Chang, Sih-Yao Chen, Fang-Hsiu Kuo, Hsin-Ju Tang, Yi-Ming Hua, Dongmei Wei, Jesus Melgarejo, Zhen-Yu Zhang, Chia-Te Liao
Annals of Intensive Care.2022;[Epub] CrossRef
Association of Sepsis-Induced Cardiomyopathy and Mortality: A Systematic Review and Meta-Analysis
Yu-Min Lin, Mei-Chuan Lee, Han Siong Toh, Wei-Ting Chang, Sih-Yao Chen, Fang-Hsiu Kuo, Hsin-Ju Tang, Yi-Ming Hua, Dongmei Wei, Jesus Melgarejo, Zhen-Yu Zhang, Chia-Te Liao
SSRN Electronic Journal .2022;[Epub] CrossRef
Sepsis-induced cardiomyopathy is associated with higher mortality rates in patients with sepsis
Balaram Krishna J Hanumanthu, Anika Sasidharan Nair, Adarsh Katamreddy, Jason S Gilbert, Jee Young You, Obiageli Lynda Offor, Ankit Kushwaha, Ankita Krishnan, Marzio Napolitano, Leonidas Palaidimos, Joaquin Morante, Seema S. Tekwani, Suchita Mehta, Aancha
Acute and Critical Care.2021; 36(3): 215. CrossRef
The Correlation Between Whole Blood Copper (Cu), Zinc (Zn) Levels and Cu/Zn Ratio and Sepsis-Induced Left Ventricular Systolic Dysfunction (SILVSD) in Patients with Septic Shock: A Single-Center Prospective Observational Study
Jian-Biao Meng, Ma-Hong Hu, Ming Zhang, Gong-Pai Hu, Wei Zhang, Shen-Jiang Hu
International Journal of General Medicine.2021; Volume 14: 7219. CrossRef

Rapid response system
Effectiveness of a daytime rapid response system in hospitalized surgical ward patients: Eunjin Yang, Hannah Lee, Sang-Min Lee, Sulhee Kim, Ho Geol Ryu, Hyun Joo Lee, Jinwoo Lee, Seung-Young Oh; Acute Crit Care. 2020;35(2):77-86. Published online May 13, 2020; DOI: https://doi.org/10.4266/acc.2019.00661

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Abstract PDF Supplementary Material

Background
Clinical deteriorations during hospitalization are often preventable with a rapid response system (RRS). We aimed to investigate the effectiveness of a daytime RRS for surgical hospitalized patients.
Methods
A retrospective cohort study was conducted in 20 general surgical wards at a 1,779-bed University hospital from August 2013 to July 2017 (August 2013 to July 2015, pre-RRS-period; August 2015 to July 2017, post-RRS-period). The primary outcome was incidence of cardiopulmonary arrest (CPA) when the RRS was operating. The secondary outcomes were the incidence of total and preventable cardiopulmonary arrest, in-hospital mortality, the percentage of “do not resuscitate” orders, and the survival of discharged CPA patients.
Results
The relative risk (RR) of CPA per 1,000 admissions during RRS operational hours (weekdays from 7 AM to 7 PM) in the post-RRS-period compared to the pre-RRS-period was 0.53 (95% confidence interval [CI], 0.25 to 1.13; P=0.099) and the RR of total CPA regardless of RRS operating hours was 0.76 (95% CI, 0.46 to 1.28; P=0.301). The preventable CPA after RRS implementation was significantly lower than that before RRS implementation (RR, 0.31; 95% CI, 0.11 to 0.88; P=0.028). There were no statistical differences in in-hospital mortality and the survival rate of patients with in-hospital cardiac arrest. Do-not-resuscitate decisions significantly increased during after RRS implementation periods compared to pre-RRS periods (RR, 1.91; 95% CI, 1.40 to 2.59; P<0.001).
Conclusions
The day-time implementation of the RRS did not significantly reduce the rate of CPA whereas the system effectively reduced the rate of preventable CPA during periods when the system was operating.

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Clinical significance of acute care surgery system as a part of hospital medical emergency team for hospitalized patients
Kyoung Won Yoon, Kyoungjin Choi, Keesang Yoo, Eunmi Gil, Chi-Min Park
Annals of Surgical Treatment and Research.2023; 104(1): 43. CrossRef
The associations between rapid response systems and their components with patient outcomes: A scoping review
Rebecca J. Piasecki, Cheryl R. Dennison Himmelfarb, Kelly T. Gleason, Rachel M. Justice, Elizabeth A. Hunt
International Journal of Nursing Studies Advances.2023; : 100134. CrossRef
Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
Acute and Critical Care.2022; 37(2): 237. CrossRef
Estructura y función de los equipos de respuesta rápida para la atención de adultos en contextos hospitalarios de alta complejidad: Revisión sistemática de alcance
Juliana Vanessa Rincón-López, Diego Larrotta-Castillo, Kelly Estrada-Orozco, Hernando Gaitán-Duarte
Revista Colombiana de Obstetricia y Ginecología.2021; 72(2): 171. CrossRef
Characteristics and Prognosis of Hospitalized Patients at High Risk of Deterioration Identified by the Rapid Response System: a Multicenter Cohort Study
Sang Hyuk Kim, Ji Young Hong, Youlim Kim
Journal of Korean Medical Science.2021;[Epub] CrossRef
Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards
Mi-Jung Yoon, Jin-Hee Park
Journal of Korean Academy of Fundamentals of Nursing.2021; 28(4): 491. CrossRef

Pediatric
Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit: Jung Eun Kwon, Da Eun Roh, Yeo Hyang Kim; Acute Crit Care. 2020;35(2):87-92. Published online May 12, 2020; DOI: https://doi.org/10.4266/acc.2019.00752

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Background
There are few studies on the effect of intensivist staffing in pediatric intensive care units (PICUs) in Korea. We aimed to evaluate the effect of pediatric intensivist staffing on treatment outcomes in a Korean hospital PICU.
Methods
We analyzed two time periods according to pediatric intensivist staffing: period 1, between November 2015 to January 2017 (no intensivist staffing, n=97) and period 2, between February 2017 to February 2018 (intensivists staffing, n=135).
Results
Median age at admission was 5.4 years (range, 0.7–10.3 years) in period 1 and 3.6 years (0.2–5.1 years) in period 2 (P=0.013). The bed occupancy rate decreased in period 2 (75%; 73%–88%) compared to period 1 (89%; 81%–94%; P=0.015). However, the monthly bed turnover rate increased in period 2 (2.2%; 1.9%–2.7%) compared to period 1 (1.5%, 1.1%– 1.7%; P=0.005). In both periods, patients with chronic neurologic illness were the most common. Patients with cardiovascular problems were more prevalent in period 2 than period 1 (P=0.008). Daytime admission occurred more frequently in period 2 than period 1 (63% vs. 39%, P<0.001). The length of PICU stay, parameters related with mechanical ventilation and tracheostomy, and pediatric Sequential Organ Failure Assessment score were not different between periods. Sudden cardiopulmonary resuscitations occurred in two cases during period 1, but no case occurred during period 2.
Conclusions
Pediatric intensivist staffing in the PICU may affect efficient ICU operations.

Citations

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Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee, Robert Jeenchen Chen
PLOS ONE.2021; 16(10): e0259092. CrossRef
Intensivists in the pediatric intensive care unit: conductors for better operational efficiency
June Dong Park
Acute and Critical Care.2020; 35(2): 115. CrossRef

CPR/Resuscitation
Measurement of mean systemic filling pressure after severe hemorrhagic shock in swine anesthetized with propofol-based total intravenous anesthesia: implications for vasopressor-free resuscitation: Athanasios Chalkias, Anastasios Koutsovasilis, Eleni Laou, Apostolos Papalois, Theodoros Xanthos; Acute Crit Care. 2020;35(2):93-101. Published online April 20, 2020; DOI: https://doi.org/10.4266/acc.2019.00773

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Abstract PDF

Background
Mean systemic filling pressure (Pmsf) is a quantitative measurement of a patient’s volume status and represents the tone of the venous reservoir. The aim of this study was to estimate Pmsf after severe hemorrhagic shock and cardiac arrest in swine anesthetized with propofol-based total intravenous anesthesia, as well as to evaluate Pmsf’s association with vasopressor-free resuscitation.
Methods
Ten healthy Landrace/Large-White piglets aged 10–12 weeks with average weight 20±1 kg were used in this study. The protocol was divided into four distinct phases: stabilization, hemorrhagic, cardiac arrest, and resuscitation phases. We measured Pmsf at 5–7.5 seconds after the onset of cardiac arrest and then every 10 seconds until 1 minute postcardiac arrest. During resuscitation, lactated Ringers was infused at a rate that aimed for a mean right atrial pressure of ≤4 mm Hg. No vasopressors were used.
Results
The mean volume of blood removed was 860±20 ml (blood loss, ~61%) and the bleeding time was 43.2±2 minutes while all animals developed pulseless electrical activity. Mean Pmsf was 4.09±1.22 mm Hg, and no significant differences in Pmsf were found until 1 minute postcardiac arrest (4.20±0.22 mm Hg at 5–7.5 seconds and 3.72±0.23 mm Hg at 55– 57.5 seconds; P=0.102). All animals achieved return of spontaneous circulation (ROSC), with mean time to ROSC being 6.1±1.7 minutes and mean administered volume being 394±20 ml.
Conclusions
For the first time, Pmsf was estimated after severe hemorrhagic shock. In this study, Pmsf remained stable during the first minute post-arrest. All animals achieved ROSC with goal-directed fluid resuscitation and no vasopressors.

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Hemodynamic Effects of Cardiovascular Medications in a Normovolemic and Hemorrhaged Yorkshire-cross Swine Model
Jacob H Cole, Scott B Hughey, Phillip G Geiger, Kamala J Rapp-Santos, Gregory J Booth
Comparative Medicine.2022; 72(1): 38. CrossRef
Determinants of venous return in steady-state physiology and asphyxia-induced circulatory shock and arrest: an experimental study
Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Giolanda Varvarousi, Dimitrios Ragias, Anastasios Koutsovasilis, Demosthenes Makris, Dimitrios Varvarousis, Nicoletta Iacovidou, Ioannis Pantazopoulos, Theodoros Xanthos
Intensive Care Medicine Experimental.2022;[Epub] CrossRef
Assessment of Dynamic Changes in Stressed Volume and Venous Return during Hyperdynamic Septic Shock
Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Vaios Spyropoulos, Evaggelia Kouskouni, Kassiani Theodoraki, Theodoros Xanthos
Journal of Personalized Medicine.2022; 12(5): 724. CrossRef
A Critical Appraisal of the Effects of Anesthetics on Immune-system Modulation in Critically Ill Patients With COVID-19
Athanasios Chalkias, Erin F. Barreto, Eleni Laou, Konstantina Kolonia, Marc H. Scheetz, Konstantinos Gourgoulianis, Ioannis Pantazopoulos, Theodoros Xanthos
Clinical Therapeutics.2021; 43(3): e57. CrossRef
Resuscitative Effect of Centhaquine (Lyfaquin®) in Hypovolemic Shock Patients: A Randomized, Multicentric, Controlled Trial
Anil Gulati, Dinesh Jain, Nilesh Radheshyam Agrawal, Prashant Rahate, Rajat Choudhuri, Soumen Das, Deba Prasad Dhibar, Madhav Prabhu, Sameer Haveri, Rohit Agarwal, Manish S. Lavhale
Advances in Therapy.2021; 38(6): 3223. CrossRef
A Multicentric, Randomized, Controlled Phase III Study of Centhaquine (Lyfaquin®) as a Resuscitative Agent in Hypovolemic Shock Patients
Anil Gulati, Rajat Choudhuri, Ajay Gupta, Saurabh Singh, S. K. Noushad Ali, Gursaran Kaur Sidhu, Parvez David Haque, Prashant Rahate, Aditya R. Bothra, Gyan P. Singh, Sanjiv Maheshwari, Deepak Jeswani, Sameer Haveri, Apurva Agarwal, Nilesh Radheshyam Agra
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Trauma
Inclusion of lactate level measured upon emergency room arrival in trauma outcome prediction models improves mortality prediction: a retrospective, single-center study: Jonghwan Moon, Kyungjin Hwang, Dukyong Yoon, Kyoungwon Jung; Acute Crit Care. 2020;35(2):102-109. Published online May 31, 2020; DOI: https://doi.org/10.4266/acc.2019.00780

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Abstract PDF

Background
This study aimed to develop a model for predicting trauma outcomes by adding arterial lactate levels measured upon emergency room (ER) arrival to existing trauma injury severity scoring systems.
Methods
We examined blunt trauma cases that were admitted to our hospital during 2010– 2014. Eligibility criteria were cases with an Injury Severity Score of ≥9, complete Trauma and Injury Severity Score (TRISS) variable data, and lactate levels that were assessed upon ER arrival. Survivor and non-survivor groups were compared and lactate-based prediction models were generated using logistic regression. We compared the predictive performances of traditional prediction models (Revised Trauma Score [RTS] and TRISS) and lactate-based models using the area under the curve (AUC) of receiver operating characteristic curves.
Results
We included 829 patients, and the in-hospital mortality rate among these patients was 21.6%. The model that used lactate levels and age provided a significantly better AUC value than the RTS model. The model with lactate added to the TRISS variables provided the highest Youden J statistic, with 86.0% sensitivity and 70.8% specificity at a cutoff value of 0.15, as well as the highest predictive value, with a significantly higher AUC than the TRISS.
Conclusions
These findings indicate that lactate testing upon ER arrival may help supplement or replace traditional physiological parameters to predict mortality outcomes among Korean trauma patients. Adding lactate levels also appears to improve the predictive abilities of existing trauma outcome prediction models.

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Yo Huh, Yura Ko, Kyungjin Hwang, Kyoungwon Jung, Yoon-ho Cha, Yoo Jin Choi, Jisook Lee, Jung Heon Kim
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Brief Communication

Intensivist/Policy
Experience of augmenting critical care capacity in Daegu during COVID-19 incident in South Korea: Je Hyeong Kim, Suk-Kyung Hong, Younghwan Kim, Ho Geol Ryu, Chi-Min Park, Young Seok Lee, Sung Jin Hong; Acute Crit Care. 2020;35(2):110-114. Published online May 31, 2020; DOI: https://doi.org/10.4266/acc.2020.00275

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Annals of Intensive Care.2022;[Epub] CrossRef
Correlation Between Third Dose of COVID-19 Vaccines and Regional Case Fatality Rates During the Omicron Wave in Korea
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JAMA Network Open.2021; 4(1): e2034266. CrossRef
Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
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PLOS ONE.2021; 16(10): e0259092. CrossRef

Editorial

Pediatric
Intensivists in the pediatric intensive care unit: conductors for better operational efficiency: June Dong Park; Acute Crit Care. 2020;35(2):115-116. Published online May 31, 2020; DOI: https://doi.org/10.4266/acc.2020.00276

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Case Reports

Pulmonary
Right ventricular assist device with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation in a patient with severe respiratory failure and right heart decompensation: Dong Kyu Oh, Tae Sun Shim, Kyung-Wook Jo, Seung-Il Park, Dong Kwan Kim, Sehoon Choi, Geun Dong Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong; Acute Crit Care. 2020;35(2):117-121. Published online April 8, 2019; DOI: https://doi.org/10.4266/acc.2018.00416

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14 Citations

Abstract PDF

Right heart decompensation is a fatal complication in patients with respiratory failure, particularly in those transitioned to lung transplantation using veno-venous extracorporeal membrane oxygenation (V-V ECMO). In these patients, veno-arterial (V-A ECMO) or veno-arterialvenous extracorporeal membrane oxygenation (V-AV ECMO) is used to support both cardiac and respiratory function. However, these processes may increase the risk of device-related complications such as bleeding, thromboembolism, and limb ischemia. In the present case, a 64-year-old male patient with idiopathic pulmonary fibrosis developed respiratory failure and commenced treatment with V-V ECMO as a bridge to lung transplantation. Unfortunately, the patient developed right heart decompensation and required both cardiac and respiratory support during treatment with V-V ECMO. Instead of adding arterial cannulation, he was switched to a novel configuration, a right ventricular assist device with an oxygenator (Oxy- RVAD) using ECMO, with drainage cannulation from the femoral vein and return cannulation to the main pulmonary artery. The patient was successfully bridged to lung transplantation without serious complications after 10 days of Oxy-RVAD support. To the best of our knowledge, this is an extreme rare and challenging case of Oxy-RVAD using ECMO in a patient successfully bridged to lung transplantation.

Citations

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Early Mobilization for a Patient With a Right Ventricular Assist Device With an Oxygenator
Sheena MacFarlane, Vanessa Lee, Adrienne H. Simonds, Samantha Alvarez, Samantha Carty, Kevin H. Ewers, Victoria R. Kelly, Parker Linden, Amanda L. Moskal
Journal of Acute Care Physical Therapy.2023; 14(1): 45. CrossRef
Right Ventricular Assist Device With Extracorporeal Membrane Oxygenation for Bridging Right Ventricular Heart Failure to Lung Transplantation: A Single-Center Case Series and Literature Review
Jae Guk Lee, Chuiyong Pak, Dong Kyu Oh, Ho Cheol Kim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Sang-Bum Hong
Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(6): 1686. CrossRef
Advanced Circulatory Support and Lung Transplantation in Pulmonary Hypertension
Marie M. Budev, James J. Yun
Cardiology Clinics.2022; 40(1): 129. CrossRef
A Review of Pulmonary Arterial Hypertension Treatment in Extracorporeal Membrane Oxygenation: A Case Series of Adult Patients
Heather Torbic, Benjamin Hohlfelder, Sudhir Krishnan, Adriano R. Tonelli
Journal of Cardiovascular Pharmacology and Therapeutics.2022; 27: 107424842110690. CrossRef
A Comprehensive Review of Mechanical Circulatory Support Devices
Varunsiri Atti, Mahesh Anantha Narayanan, Brijesh Patel, Sudarshan Balla, Aleem Siddique, Scott Lundgren, Poonam Velagapudi
Heart International.2022; 16(1): 37. CrossRef
Comprehensive Monitoring in Patients With Dual Lumen Right Atrium to Pulmonary Artery Right Ventricular Assist Device
Asad A. Usman, Audrey E. Spelde, Michael Ibrahim, Marisa Cevasco, Christian Bermudez, Emily MacKay, Sameer Khandhar, Wilson Szeto, William Vernick, Jacob Gutsche
ASAIO Journal.2022; 68(12): 1461. CrossRef
Percutaneous Pulmonary Artery Cannulation to Treat Acute Secondary Right Heart Failure While on Veno-venous Extracorporeal Membrane Oxygenation
Kelly M. Ivins-O’Keefe, Michael S. Cahill, Arthur R. Mielke, Michal J. Sobieszczyk, Valerie G. Sams, Phillip E. Mason, Matthew D. Read
ASAIO Journal.2022; 68(12): 1483. CrossRef
The ProtekDuo for percutaneous V-P and V-VP ECMO in patients with COVID-19 ARDS
Ahmed M El Banayosy, Aly El Banayosy, Joseph M Brewer, Mircea R Mihu, Jaclyn M Chidester, Laura V Swant, Robert S Schoaps, Ammar Sharif, Marc O Maybauer
The International Journal of Artificial Organs.2022; 45(12): 1006. CrossRef
Critical Care Management of the Patient with Pulmonary Hypertension
Christopher J. Mullin, Corey E. Ventetuolo
Clinics in Chest Medicine.2021; 42(1): 155. CrossRef
Oxy-right Ventricular Assist Device for Bridging of Right Heart Failure to Lung Transplantation
Sung Kwang Lee, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo
Transplantation.2021; 105(7): 1610. CrossRef
Interventional and Surgical Treatments for Pulmonary Arterial Hypertension
Tomasz Stącel, Magdalena Latos, Maciej Urlik, Mirosław Nęcki, Remigiusz Antończyk, Tomasz Hrapkowicz, Marcin Kurzyna, Marek Ochman
Journal of Clinical Medicine.2021; 10(15): 3326. CrossRef
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(12): 3496. CrossRef
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: An Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
Anesthesia & Analgesia.2021; 133(6): 1459. CrossRef
Successful Lung Transplantation After 213 Days of Extracorporeal Life Support
Jae Kyeom Sim, Kyeongman Jeon, Gee Young Suh, Suryeun Chung, Yang Hyun Cho
ASAIO Journal.2020;[Epub] CrossRef

Pulmonary
Lung injury associated with inhalation of effective microorganism blends: Jee-min Kim, Yoon Jin Kwak, Ho Il Yoon; Acute Crit Care. 2020;35(2):122-126. Published online April 8, 2019; DOI: https://doi.org/10.4266/acc.2018.00332

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Abstract PDF: Since 2009, effective microorganisms (EMs) have been supplied by the local government to the citizens of Seongnam, Korea, for various environment-protective uses including manufacturing detergents, cosmetics and humidifier disinfectants. A 68-year-old man who had placed an EM blends into a humidifier for inhalation visited the emergency room with complaints of fever and dyspnea. He was in a shock state with hypoxia. Chest computed tomography revealed diffuse ground-glass opacities that were dominant in the bilateral upper lobes. Fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial lung biopsy was performed. Bronchoalveolar lavage fluid analysis and biopsy findings were consistent with alveolar hemorrhage. All microbiological and virological test results were negative. His symptoms and radiographic opacities had improved markedly after several days of conservative care, and he was discharged healthy after 1 week of hospital stay.

Letter to the Editor

Pulmonary
Is percutaneous dilatational tracheostomy with bronchoscopic guidance better than without?: Jinsun Chang, Hong-Joon Shin, Yong-Soo Kwon, Yu-Il Kim, Sung-Chul Lim, Tae-Ok Kim; Acute Crit Care. 2020;35(2):127-129. Published online May 31, 2020; DOI: https://doi.org/10.4266/acc.2020.00101

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98 Download

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